Problems_of_the_Breast - Problems of the Breast Benign...

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Problems of the Breast Benign Disorders o Fibroadenoma o Fibrocystic changes : nonspecific diagnosis for a condition marked by palpable lumps in the breasts. Usually associated with pain & tenderness that fluctuates with menstrual cycle. Usually 50% of women of reproductive age have palpably irregular breasts caused by this condition. o Ductal Ectasia: o Intraductal Papilloma: solitary neoplasm of the breast that occurs in the large, lactiferous ducts. A distinct neoplasm that displays a papillary histological pattern. --------------------------------------------------------------------------------------------------- Fibroadenoma o Most common benign tumor of breast o Occur most often during adolescence and early 20’s o Firm, freely mobile nodules composed of fibrous & glandular tissue o May or may not be tender upon palpation o Do not change with cycle o Not unusual for more than 1 to be present o Located in upper outer quadrant o Treat by observing or remove to determine if malignant --------------------------------------------------------------------------------------------------- Fibrocystic Breast Changes o Mammary Dysplasia o Early stages: fibrosis or thickening of breast tissue. Later stages: cysts form and are felt as multiple, smooth, well-delineated nodules. o Most common breast disorder during reproductive years o Not a disease but may represent the way a woman’s breasts respond to normal monthly hormone luctuations o Often occur before menopause o May be present bilaterally S/S o Pain and tenderness – most common symptom o Most noticeable premenstrual d/t imbalance of estrogen-progestin production o Often bilateral o Round shape o Soft, firm, mobile o Improve during pregnancy and lactation d/t large amts of progestin produced Treatment o R/O malignancy by mammogram, fine needle aspiration, biopsy o Medical treatment is not standardized. Side effects of drugs often more distressing than breast 1
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discomfort o May treat with Medroxyprogesterone acetate, Tamoxifen , Danazol o Caffeine: may contribute to development of fibrocystic breast changes. She may be told to limit consumption. Controversial. --------------------------------------------------------------------------------------------------- Ductal Ectasia o Usually occurs in women approaching menopause o Dilation of collecting ducts – become distended and fill with cellular debris o inflammatory process resulting in o firm, irregular mass Enlarged axillary nodes Nipple retraction and discharge o No treatment necessary o Similar to symptoms of breast cancer & must be differentiated from breast ca via surgical biopsy --------------------------------------------------------------------------------------------------- Intraductal Papilloma o Typically develops just before or during menopause o Most papillomas/lesions occur in epithelium of ducts of breasts - areola o
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